Overview of DNP Residency and Project

1. Overview of DNPResidency and Project Robin Bissinger, PhD, APRN, NNP-BC Medical University of South Carolina College of Nursing

2. Welcome • Team of faculty to assist you • Advisement Team • Director of Graduate Program • Graduate Program Coordinator • Director of Student Services • Clinical Placement Coordinator • Site agreements and preceptors • Practice Inquiry Project Coordinator

3. DNP: Doctoral Degree for Practice • It is a practice doctorate • New Consensus model for practice • APRN: 4 roles • CNM, CNP, CRNA, CNS • Population Foci: 6 • Family/Individual across the lifespan (FNP) • Adult Gerontology • Neonatal • Pediatrics • Women’s Health/Gender Related • Psych-Mental Health

4. DNP Competencies • Eight essentials for doctoral education for APRNs • Scientific underpinnings for practice • Organizational and Systems leadership for Quality Improvement and Systems thinking • Clinical Scholarship and Analytic Methods for Evidence-based Practice • Understanding of translational research, evidence-based practice and process improvement • Information systems/Technology and Patient Care Technology for the Improvement and Transformation of health care • Health Care Policy for Advocacy in Health Care • Inter-professional Collaboration for Improving Patient and Population Health Outcomes • Clinical Prevention and Population Health for improving the Nation’s Health • Advanced Nursing Practice • The practice of clinical nursing at the highest level

5. DNP Program • Full or Part time plan of study • Signed and agreed to by the student • If you change from FT/PT or PT/FT we have to revise and sign a new plan of study • Use your program plan to register for your courses each semester • Email advising you to register and time to contact us if you have any questions or concerns • Check your MUSC email daily for information

6. DNP Program Needs • My-Folio • Sign honor code • Upload your CV and keep current copy uploaded • Upload a current picture • Tell us your 2 sentence elevator speech • “What is a DNP” • Sign that you have reviewed the DNP and CON student handbooks both are posted on the web site • Maintain current MUSC requirements (i.e. BCLS)

7. Residency • Key component of the DNP Program • Combines clinical practice experiences with scholarly activities (500 hours for a total of 1000 hours) • Two components • Comprehensive clinical experience • 400 Precepted Hours • Broadens exposure in your APN specialty • Does not provide a new specialty • Practice Inquiry Project • 100 hours

8. Residency • Key Aspects • Integrative practicum for DNP students • Completed in the final year of the program • Key component of DNP education • Synthesis of knowledge • Ongoing Portfolio development (My-Folio)

9. Residency • Individually designed by each student • Set your own clinical goals • Approved by Residency Coordinator • Demonstration of increasingly complex and proficient practice • Clinical hours • Procedural • Refined communication, reflection and scholarly skills • MyFolio • Reflective Journaling • Scholarly Activities • Competencies • Patient care expertise with emphasis on independent and inter-professional clinical practice • Typhon clinical logs • Clinical and Preceptor contracts • Health Policy and Health Care delivery Projects

10. Clinical Residency • Clinical Placement Coordinator: Lee Horton • Clinical Site • Clinical Site Approval form • Faxed to Graduate Program Coordinator (Douglass) • Goes to Clinical Placement Coordinator for Approval • Once site approved: Affiliation Agreement Request Form • Faxed to Graduate Program Coordinator • Must have Legal facility agreement to start residency work • Clinical Preceptor • With expertise in clinical practice • Nationally certified • Complete clinical preceptor form, attach CV, copy of license and certification (Send to Graduate Program Coordinator: Douglass)

11. Residency Contract • Purpose of residency is to increase exposure to doctoral level clinical practice • DNP Clinical Residency Contract • Specific objectives, requirements and evaluation criteria • Specified number of hours for each contract • Completion of contract to successfully meet residency requirement • Final decision by residency course coordinator • Contract must be developed by the student and agreed on by clinical preceptor and residency course coordinator • Signed by the student, clinical preceptor and residency course coordinator. • Placed in academic record

12. Reflective Journal • Integration of clinical leadership and inquiry into previous or current practice • Utilize clinical cases from your experience or practice • Integration of ethics, genetics, heath policy, collaboration and information technology, health disparity and other areas of doctoral level practice • This is a tangible, deliverable academic product • Example • Identify a potential genetic risk in a population of patients you have cared for and discuss a diagnosis of a genetic condition and an intervention you made for an individual in your practice. Discuss the implications for the families. What did you learn from the experience? Would you do anything different? Provide a critical analysis and discussion. (Upload this to MyFolio)

13. Scholarly Activities • Academic and Scholarly activities • Conferences, seminars, journal club, grand rounds, morbidity and mortality, patient conferences, quality and safety, practice-based lectures, interdisciplinary committees, quality improvement committees, policy or advocacy events • Each student is expected to document a minimum of 10 activities during residency • On My-Folio: under Residency you will find this section

14. Residency Competencies • Domains and Competencies for DNP education and APRN practice must be met within the program. • These are the skills, knowledge and attitudes required for clinical practice (referred to as competencies) • Some are met in course work • Others are met by students with documentation provided by you in MyFolio • Each Domain and competency is outlined in MyFolio • Required to review competencies and complete any tasks • Example • Competency 22: Counsels the patient on the use of complementary/alternative therapies (see task) • In one paragraph describe how you counseled a patient on the use of complementary therapies.

15. Residency Evaluation Evaluation of Clinical site Evaluation of Clinical Preceptors Evaluation of Residency Course Evaluation of Residency Course Coordinator

16. Practice Inquiry Project • Use of research knowledge and methods to create, implement and evaluate practice interventions, health delivery systems, and clinical teaching. • Commitment to translate research into practice in order to improve health care outcomes • Project in an area of clinical practice, expertise or interest • A practice change initiative • Program implementation and evaluation • Practice model implementation and evaluation • Health policy implementation • Quality improvement project

17. MyFolio • MyFolio is used instead of a written proposal • Pieces of the Practice Inquiry Project are built in some of your courses • Example: NRDP 844 Research Use and Evidence Based Practice • Section 1: Introduction and Statement of Problem • Section 3: State of the Science Paper • Example: NRPHD: Knowledge Dissemination and Translation • Section 2: Philosophical or theoretical perspective • These pieces will assist you when you write your paper for publication in your last residency course • IRB approval must be uploaded (exempt/expedited) • CITI training certificate must be uploaded

18. Guidelines Project is related to advanced practice in the nursing specialty and benefits a group, population or community rather than an individual My be done in partnership with an agency or group but student must have the leadership role or can be solo Students work with the Practice Inquiry Project Coordinator to develop the project (Dr. Edlund) Must go through IRB at MUSC and your center

19. Faculty Committee • Three members • Practice Inquiry Project Coordinator • Clinical advisor or mentor at your site • National expert or person with interest in area • Complete Practice Inquiry Project Topic and Committee member form with all there of the above signatures agreeing to be part of your committee • Deadline for forming the committee • Post MSN/DNP: by end of the first semester • Post BSN/DNP: by fall of the second year

20. Practice Inquiry Project • Components are threaded throughout your program • Upload those components in the MyFolio • Approval by your course instructor • Approval by the Practice Inquiry Project Coordinator • Communication with your PIP committee is essential each step of development • Cannot be started until you have IRB approval and you must be in your residency course

21. PIP Framework • Focus-PDSA approach • F: Find a process to improve • What do you plan to change • Organize an effort to work on improvement • Who will be involved and what support do you need • Clarify the current knowledge of the process • What is the current state of the science related to the process or practice • Understand process variation and performance capabilities • Outline specifically how the current process works • Select changes aimed at performance or process improvement • Choose the intervention or interventions • What changes are you going to make

22. PIP Framework • Plan the change. Analyze and predict the results • How do you plan to measure the effect of the change • Do it • Execute the plan taking small steps in controlled circumstances • Study it • Check or study the results • Act: Take action • How do you sustain the gain • If no working what is the next step (Continue PDSA)

23. Program Milestones • Completion and presentation of the Practice Inquiry Project Proposal (in Charleston) • Must have proposal approval sheet with you • Must have committee on board • Plan to have distance members on-line • Final Poster presentation of completed project (in Charleston) • Must have final completion paperwork with you • Consider having committee members present • Submission of paper for publication • Paper approved by faculty with all revisions • Journal proof of submission • Residency: Completion of all 500 hours

24. Final Project Work • Final proposal is completed in NRDNP 852 Health Program Planning • Final paper and poster are due in your last residency (NRDNP 890) • Two weeks prior to the poster presentation • All sections of MyFolio must be complete • Publication must be approved and all revisions made • Poster presentation • Electronic publication must be uploaded with proof of submission to journal • Poster is presented with a 10 minute oral-summary • Committee signs off on your work with recommendation for the DNP degree

25. Contact us • Stay in touch • Send emails with questions and concerns • Consider being on the Graduate Program Committee and EPEC committee to represent your group • If you are struggling call early so we can help • Understand one thing: • “Our Goal is that everyone will graduate, do well and represent the CON as a strong APRN leader” • Follow up with us after graduation: Alumni survey, employer survey and graduation survey

26. QUESTIONS?